This research uses available data from a unique longitudinal study of primary care to operationalize the Network-Episode Model of access to child mental health services (Costello et al., 1998). The research 1) describes through latent class analysis how structural family characteristics, family functioning, and help seeking create the construct of family networks, which may influence the parent and provider recognition of youth mental health need, 2) explain what primary care provider characteristics are related to the recognition of youth mental health needs, and 3) relate family networks and provider characteristics to the delivery and outcomes of mental health services within primary care. The family and provider participants are socioeconomically and geographically diverse. The instrumentation used to measure recognition of mental health needs accounts for symptoms, functional impairment, and burden. Prospective longitudinal methods are used to assess service delivery and outcomes. Methods include latent class analysis, generalized estimating equations, and survival analysis. This research will potentially impact clinical practice, guide future research, and be useful for the design of interventions to increase access to youth mental health services.